Re-imagining the Future in Papua New Guinea

Lisa SchechtmanLisa Schechtman is the head of policy and advocacy at WaterAid in America, the U.S. member of WaterAid International, the world’s largest NGO focused on providing safe drinking water, sanitation and hygiene education (WASH) services for poor communities in 27 countries around the world. Prior to joining WaterAid, Lisa served as policy director at the Global AIDS Alliance, and was a member of the Developed Country NGO Delegation to the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Lisa has a Masters of Arts in International Human Rights and Global Health Affairs from the University of Denver, and a B.A. in English Literature and French Language from Northwestern University. She is based in Washington, DC.

Papua New Guinea (PNG) is a small country in the south Pacific not too far from Australia’s northern-most tip. It’s fascinating and beautiful, made up of more than 600 islands and 800 languages. A full 86% of the population lives in rural areas, many nowhere near even a dirt road. In our world of rapid urbanization and homogenization, this is almost unheard of.

PNG is so far from the United States that most Americans know nothing about it. In late May, I got a crash-course when I joined a delegation to explore a new partnership between my organization, WaterAid, the world’s largest organization focused on safe drinking water, sanitation and hygiene (WASH), and a small local organization called Susu Mamas (roughly translated as “breastfeeding mothers”), which provides maternal and child health care in the Western Highlands Province of PNG’s mainland.

Our goal was to figure out how to work together to best meet some very basic needs for people in the Western Highlands, which is almost entirely rural and further marginalized by mountainous terrain and ethnic diversity. Together, we will support efforts to ensure that safe water storage, sanitation and hygiene are built into Susu Mamas’ work with mothers-to-be and their families in their brick-and-mortar clinic in the small city of Mt. Hagen, the communities where Susu Mamas staff does regular outreach, and the government-backed aid outposts Susu Mamas will help reopen in coming months.

Despite PNG’s status as a rising middle-income country, the need for basic services like safe drinking water, toilets and hygiene education is huge, on par with some of the world’s poorest countries:

•A mere 19% of the population has access to a basic pit latrine or better.

•Only 40% has access to a safe source of drinking water.

Papua New Guinea is one of the only countries in the world whose overall health indicators are gettingworse, not better.

Neonatal deaths (that’s the 28 days after birth) from water-related diseases including malaria and diarrhea are on the rise. Rates of child deaths from pneumonia have been steady for a decade, fueled by indoor air pollution, often from cooking over open fires inside homes such as Elizabeth’s (see photo), and poor hygiene. Despite the fact that handwashing with soap has been shown to reduce this respiratory infection by up to 50%, both hand soap and clean cookstoves were out of reach for the families I met. In fact, a mother in one village we visited approached Susu Mamas health workers, saying she thought her baby had pneumonia. The nurses not only concurred but rushed mom and baby to hospital a few kilometers away. I never heard whether the baby survived.

The moms in that village had no well that I could see, and what latrines did exist were too shallow to be safe and too clean to have been used very often. Some families said they drink from a run-off stream that looked brackish to me. Others, sensing (correctly) that contamination increases downstream, spend an hour or more climbing up the mountain every morning to collect water, only to carry their cumbersome load awkwardly down the hill and home again.

Given all they must do to collect this hard-won resource, suggesting it be used for handwashing seemed almost too much. Most household water I saw was stored uncovered, creating a breeding ground for mosquitoes that spread malaria or dengue fever, and a catchment for bacteria and parasites. Bellies were distended from worms, skin rough with infection, and reports of diarrhea, malaria and costly hospitalizations all too common.

The partnership between WaterAid and Susu Mamas can’t fix all of this single-handedly. It is our hope that by supporting Susu Mamas staff, WaterAid can help them effectively translate the importance of clean water, toilets and good hygiene practices to the families they serve. When people realize just how much WASH can help them accomplish their goals of health and well-being, there is almost no stopping them from demanding government services and becoming sanitation and hygiene leaders in their own homes. WaterAid’s role as a capacity builder is about to be put to the test in Papua New Guinea. Between excellent WaterAid community liaisons, outstanding midwives and community workers at Susu Mamas, and dedicated parents all over Papua New Guinea, I am confident we’ll succeed in helping communities change their lives for the better.

The pit latrine used by Steven, a pastor, and his wife Miriam, and their family. The latrine is shared by three households in total, but appeared quite clean for that level of use. The family gets its drinking water by climbing an hour up the mountain in hopes of avoiding contamination downstream; their washing water comes from a nearby run-off stream. Ketapam II, Western Highlands Province, Papua New Guinea. –WaterAid/Lisa Schechtman

Elizabeth, age unknown, inside her home. Behind her are two long-lasting insecticide-treated bed nets to prevent malaria; to her right out of view is a rudimentary cookstove whose smoke has no ventilation. The family, which includes five children, reports that their primary health concerns is feeling ill with malaria, despite having these nets. Ketapam II, Western Highlands Province, Papua New Guinea. -WaterAid/Lisa Schechtman